top of page

Q4 2024 Home-Based Care M&A Report

Updated: Jan 29

Headline: Home-Based Care M&A Report: Q4 2024

The slowdown continued.


But the pick-up is happening.


After a booming M&A landscape in 2021 gave way to a moderate 2022 and 2023, home-based care dealmaking slowed considerably in 2024, dropping from 183 deals in 2021 to 110 in 2023 down to just 72 in 2024.


That decline in 2024 ended with just 14 transactions in Q4, tied for the lowest quarter for home-based care M&A activity since the pandemic. But don’t expect things to stay that way.


“Things are starting to move,” says Cory Mertz, Managing Partner at Mertz Taggart. “More transactions are moving forward. They just haven’t gotten across the finish line. But expect they will in 2025.  At the risk of getting ahead of ourselves, we’re seeing a fast start to Q1 2025, in terms of deals closed.”

Note: Total industry transactions do not necessarily equal the sum of the sub-industries, as many transactions include more than one sub-industry.
Note: Total industry transactions do not necessarily equal the sum of the sub-industries, as many transactions include more than one sub-industry.

Home care led the way with eight transactions, followed by six in hospice and just two in home health. Nine of the deals featured PE-backed companies.


Election Impact on Home-Based Care M&A

The most significant event in Q4 was undoubtedly the election.  While impacts from DOGE and the current administration’s view on Medicaid funding (and its potential impact on home-based care) are not yet known, positively or negatively, the Trump administration is expected to bring a positive shift to the healthcare M&A landscape by encouraging private sector growth and reducing regulatory hurdles. Recent scrutiny of private equity investment in healthcare in the form of legislation at both the federal and state levels has created uncertainty in the market, but the new administration’s anti-regulatory stance could reverse this trend and foster a more transaction-friendly environment. Added Mertz, “By focusing on deregulation, the administration is creating a climate where private equity investors have more confidence they can get deals more efficiently, unlocking opportunities in the healthcare sector.”


Home Health M&A 

Of the past 16 quarters, the two lowest quarters in home health M&A came in 2024: Q1, with four deals completed, and Q4, with just two. The first of those two was announced on October 13, when Brooklyn-based home health care agency Prime Home Health Services acquired the assets of Visiting Nurse Association of Staten Island (VNASI), which had ended its operations September 27.

“That operation closed down, and Prime will do our best to continue to service the community by using and recognizing the name and how it resonates,” Prime Home Health Services CEO Christopher Doulos said in a statement.


The second deal came less than a month later, when Choice Health at Home acquired the Oklahoma City-based Accentra Home Health and Hospice. As Choice noted, the acquisition means it will be able to cover 90% of Oklahoma’s urban and rural geographies.


“This will improve the lives of our nurses, there will be less travel time and more density of patients in the metro areas,” Choice CEO David Jackson told Home Health Care News. “But also, it gives us the license numbers in the state to really be able to reach out and touch people in the rural areas as well. So, from a strategic planning perspective, we want to cover the Southwest, with Oklahoma included. Within that, we’re really intent on providing care in rural and urban settings, and this gives us the opportunity to do so.”



Hospice M&A

Choice’s acquisition of Accentra is also a hospice transaction, one of five that closed in Q4. The other four were all solely hospice. Hospice transaction activity has taken the biggest hit post-COVID of any of the three sectors; 2024 saw 25 hospice deals, down from 30 in 2023, 41 in 2022 and 81 in 2021.

The four other hospice deals in Q4:

  • Private equity firm Martis Capital acquired Dallas-based Three Oaks Hospice for $150 million.

  • Chapters Health System acquired four non-profit hospices, including Hospice of Santa Cruz County.

  • Long-term care company Mission Health Services acquired Utah-based Angel’s Crossing Home Hospice.

  • Nevada-based Eden Health acquired A Plus Hospice Care.


“This acquisition represented an expansion opportunity into an adjacent market within a state where the buyer, Eden Health, had developed a growing footprint,” Spencer Walters, senior director of Eden Health, told Hospice News in an email. “Eden Health has successfully grown their regional presence by supplementing organic growth efforts with an aggressive acquisition strategy.”



Home Care M&A

The busiest sector in Q4 was home care, with eight deals completed.  The biggest mover: Vistria-backed Help at Home, who completed four transactions in the quarter, including Helpmates Home Nurses in Pennsylvania, and Florida-based Caregiver Services (CSI).


“CSI knows what it takes to be an employer that can cultivate a compassionate care workforce, and they’re also focused on providing high-quality care and being a trusted partner with the state of Florida and their payers in the communities they serve,” Ray Smithberger, chief operating officer of Help at Home, told Home Health Care News following the deal.

Other notable transactions in Q4 include:


  • Canada-based Nova Leap Health acquired a Florida-based private duty home care agency in Florida.  While the selling company’s name has been withheld at Nova Leap’s request, the financial terms were made public.  

  • Nashville-based Avenues Home Care acquired Texas-based Clear Path Home Care.

  • Havencrest-backed Avid Health at Home, LLC acquired Sandhills Home Care in North Carolina.



2025 Outlook

“We expect activity to pick up in 2025 relative to 2024.  There is too much pent-up demand from private equity, driven by aging dry powder.  These are committed funds from their LP investors that they have not yet been able to invest. Leaving committed funds uninvested can make raising their next fund more of a challenge, so there is an impetus to invest now,” Mertz said. “We also expect to see more activity by sponsor-backed portfolio companies seeking an exit.  Some of them have shared with us that they’ve held off on their previously planned exits and see 2025 as the year to transact so they can ultimately give their investors a return on their capital.  If it’s a successful exit, and many will be, they will then be armed with good results that they can boast as they raise their next fund.”


If you are interested, you can also download the Q4 2024 Home-Based Care M&A Report via the following link:



Comments


bottom of page